Clinical Preventive Services for Older Adults
An Aging Population
By 2030, the number of Americans aged 65 years and older is estimated to be 71.5 million, more than double what it is now. That is larger than the current combined population of the entire states of California, Texas, and New Jersey! This has far-reaching implications for public health and aging-related services. Recognizing these trends, several public health initiatives are focused on keeping older adults healthy and active so they can continue as vital members of communities where they live, learn, work, and play.
Older Adult Topic Area added to Healthy People 2020
he recently released Healthy People 2020 provides national objectives for improving the health of all Americans. For the first time it includes objectives aimed at the goal, "Improve the health, function and quality of life for older adults." The Older Adults topic area is designed to specifically guide national health promotion and disease prevention efforts by setting science-based benchmarks to monitor progress, while directing and focusing public health action in critical areas.
Clinical Preventive Services for Older Adults
Potentially life-saving clinical preventive services can be critically important in preventing, forestalling, or detecting disease early when treatment is most effective. The U.S. Preventive Services Task Force (USPSTF) recommends a set of clinical preventive services for persons aged 65 years and older. For a complete list of all recommended services, see the USPSTF Web site at http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm. Among the recommended preventive services are a core set of services, based on age and gender. These core services include influenza and pneumococcal vaccinations, lipid disorders, colorectal cancer screening, and additionally for women, breast cancer screening.
Less than half of adults aged 65 years and older are up to date with this core set of clinical preventive services. This is true despite the fact that these services are paid for by nearly all insurance plans, including Medicare and Medicaid. The Older Adult topic area in Healthy People 2020 includes an objective: Increasing the proportion of older adults who are up to date on the core set of clinical preventive services. The target of this objective is to increase by 10 percent the proportion of men (from 46.3% to 50.9%) and women (from 47.9% to 52.7%) who are up to date on the core set of clinical preventive services by the year 2020. This approach aims to provide a more meaningful measure of the delivery of clinical preventive services in the community.
Increasing Access to Clinical Preventive Services through Community Linkages
An overarching goal of Healthy People 2020 is to achieve health equity and eliminate disparities. Addressing disparities observed among older adults not currently receiving clinical preventive services will require strategies that broaden access to services beyond the traditional health care settings. A report released in March 2011, Enhancing Use of Clinical Preventive Services Among Older Adults: Closing the Gap [PDF - 10.1 MB], calls attention to the many obstacles in providing preventive services to people aged 65 years and older who are not up to date with current recommendations. Highlighted in the report is the need for linking community and clinical strategies focusing on underserved populations.
An example of linking community and clinical strategies to increase access to preventive services is the Sickness Prevention Achieved through Regional Collaboration (SPARC) program. SPARC has documented the success of its approach in a four-county area of New England. The program also has been successfully piloted in two metropolitan counties in Atlanta, Georgia. SPARC projects have doubled the use of breast cancer screening by making mammography appointments available at influenza (flu) vaccination clinics, and also have doubled the use of pneumococcal vaccinations by broadly increasing access to the vaccination across multiple counties. The accomplishments of the program are due in large part to a focus on convenience for individuals, by offering services in non-traditional settings such as beauty salons, churches, barbershops, and polling places, and by "bundling" access to multiple clinical preventive services whenever possible.
Another successful strategy developed by SPARC is Vote & Vax, an initiative that makes vaccinations available at polling places on election days. Vote & Vax delivered more than 21,000 flu vaccinations on a single day in 2008 at 331 locations in 42 states and the District of Columbia. Of those vaccinated, approximately half were not regular flu vaccination recipients; thereby, expanding protection from influenza. The reach was even greater among traditionally underserved populations. For example, 60.2 percent of African-American and 64.8 percent of Hispanic recipients reported that they did not regularly receive a flu vaccination.
Additional Resources for Clinical Preventive Services
The Guide to Community Preventive Services is a resource for evidence-based recommendations and findings about programs and policies to improve health and prevent disease in community settings. Among its many recommendations are ways to increase vaccination rates within targeted populations through community-based interventions in combination with coordinated community activities that increase demand for vaccinations and enhance access to vaccination services.
The Department for Health and Human Services developed a Web site, healthfinder.gov that includes an interactive tool with information about preventive services recommended based on age and sex. The site provides resources on a wide range of health topics from over 1,600 government and non-profit organizations. Additionally, the Agency for Healthcare Research and Quality (AHRQ) developed an Electronic Preventive Services Selector (ePSS) designed for primary care physicians to identify appropriate USPSTF-recommended preventive services for their patients, available both as a web-based selector and as a downloadable PDA application.
Continuing to identify and implement public health strategies that expand the delivery of clinical preventive services will help ensure that older adults receive potentially life-saving vaccinations and disease screenings. Doing so will enable older adults to live healthier lives for longer periods so they can continue to play vital roles in their communities.
Additional public health initiatives for living healthier, longer, and more productive lives:
- Page last reviewed: May 9, 2011
- Page last updated: May 9, 2011
- Content source:
- National Center for Chronic Disease Prevention and Health Promotion
- Page maintained by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs